ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2857

The 8-Year Retention Rate of the First TNF-Inhibitor in the Treatment of Spondyloarthropathies: Real-Life Data from Three Local Registries

Ennio Giulio Favalli1, Andrea Becciolini1, Martina Biggioggero2, Enrico Fusaro3, Simone Parisi3, Alarico Ariani4, Daniele Santilli4, Antonio Marchesoni1 and Pier Luigi Meroni2, 1Department of Rheumatology, Gaetano Pini Institute, Milan, Italy, 2University of Milan, Department of Clinical Sciences and Community Health, Division of Rheumatology, Gaetano Pini Institute, Milan, Italy, 3Città della salute e della Scienza, Turin, Italy, 4Department of Internal Medicine and Rheumatology, University of Parma, Parma, Italy

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Tuesday, November 10, 2015

Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment Poster III: Therapy

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Long-term data on drug survival of TNF inhibitors (TNFi) in the treatment of spondyloarthropathies are still lacking. The aim of the study is to analyze in a setting of real-life the 8-year retention rate of the first TNFi for the treatment of psoriatic arthritis (PsA) and axial  spondyloarthritis (ax-SpA) and to compare the between-group discontinuation rates for each TNFi (infliximab [IFX], etanercept [ETN], and adalimumab [ADA]). 

Methods: Data were retrospectively extracted from three local registries including all patients affected by PsA and ax-SpA treated with a biologic drug between January 2002 and May 2014. The analysis was limited to patients treated with IFX, ETN, or ADA as first-line biologic agent, with at least 1-year follow-up period. The 8-year drug survival was evaluated by Kaplan-Meier method and the risk for discontinuation among the 3 treatment groups was compared by a stratified log-rank test. The comparison of reasons for drug withdrawal among treatment subgroups was performed by the Fischer’s exact test. 

Results: The study population (594 patients) included  322 ax-SpA (69.2% male, median age [±SD] 42 [±12.2] years, median disease duration 5.2 [±8] years), treated with ADA (n=99), ETN (n=40), or IFX (n=183); and 272 PsA (53.7% male, median age 47.9 [±12.2] years, median disease duration 9.1 [±7.3] years), treated with ADA (n=98), ETN (n=75), or IFX (n=99).  The overall median survival on treatment of the whole study population was 103.6 months (105.2 and 102.6 months for ax-SpA and PsA, respectively;  p=0.3768). The overall retention rate was 62.8% (68.4% versus 59.7% in axSpA and PsA, respectively) at 5 years and 53.3% (56.1% versus 52.4% in axSpA and PsA, respectively) at 8 years. No significant differences emerged  in the comparison among  ADA, ETN, and IFX in both ax-SpA group (p=0.1113) and PsA group (p=0.4783). The main reported reasons for treatment discontinuation were drug inefficacy (18.2% in ax-SpA versus 25.6% in PsA; p=0.0357) and adverse events (16.4% in ax-SpA and 19.2% in PsA; p=0.45).

Conclusion: In a real-life setting, the 8-year retention rate of the first TNFi in the treatment of spondyloarthropathies was about 50%, with no significant difference between ax-SpA and PsA. The risk of stopping IFX, ETN, and ADA treatment was similar in both ax-SpA and PsA group. 

Disclosure: E. G. Favalli, None; A. Becciolini, None; M. Biggioggero, None; E. Fusaro, None; S. Parisi, None; A. Ariani, None; D. Santilli, None; A. Marchesoni, None; P. L. Meroni, None.

To cite this abstract in AMA style:

Favalli EG, Becciolini A, Biggioggero M, Fusaro E, Parisi S, Ariani A, Santilli D, Marchesoni A, Meroni PL. The 8-Year Retention Rate of the First TNF-Inhibitor in the Treatment of Spondyloarthropathies: Real-Life Data from Three Local Registries [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-8-year-retention-rate-of-the-first-tnf-inhibitor-in-the-treatment-of-spondyloarthropathies-real-life-data-from-three-local-registries/. Accessed .

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